The exact causes of fibromyalgia are not yet known to the medical world. Probably, there are many factors involved.
For example, some patients explain that they have developed it after physical or emotional stress. Others relate it to a trauma, or specific illness. However, in most cases, it seems to occur without apparent cause.
The most likely hypothesis is that fibromyalgia is actually a disorder in the way the body processes pain, or more specifically, an increase in sensitivity to stimuli that in normal people are not painful.
Research on the causes of FM is very intense, including analyzing data on how the central nervous system (brain and spinal cord) processes pain. Several studies indicate that people who have a family member affected by this disorder are more likely to develop it. The exact reasons to explain this fact are not known. It could be the inheritance or the shared environment. Therefore, the genetic factors that may be involved in the origin of FM are being actively studied.
Some scientists theorize that at least in part, the genes that regulate/modulate pain are involved. According to this theory, the patients have a gene or genes that should be causing an anomaly (more intense) response to different stimuli, which for other people are not painful. Several genes have been identified that seem to modulate the response to painful stimuli.
On the other hand, there seems to be a disorder at the level of the autonomic nervous system (the one in charge of non-conscious functions such as breathing, heart beating, etc.) that triggers hyperactivity in the face of stress.
Disorders of the pituitary-hypothalamic-adrenal axis have also been described as a mechanism that the body also uses in the response to stress.
How To Diagnose Fibromyalgia?
The reality is that patients with FM before being diagnosed usually visit many doctors. Probably because the pain and fatigue overlap with many other signs and symptoms, apparently unrelated. For this reason, medical teams have to rule out other potential causes of the symptoms before diagnosing FM. To this, we may add that at present, there’s no certain diagnostic test. Due to these reasons, some doctors unfortunately conclude that the pain of the patients is not real.
In most cases, medical personnel trained in the diagnosis of FM can diagnose it with relative ease. The most recognizable symptom is a relative history of generalized pain, lasting more than 3 months, accompanied by sensitivity to spread the pain. By excluding other diseases that can cause pain and fatigue, it would be enough in principle to make the diagnosis.
Pain is considered to be generalized when it affects the 4 quadrants of the body. The American Academy of Rheumatology (ACR) has established 18 points of the organism as especially painful points to pressure. In order to strictly comply with the ACR classification criteria, the presence of 11 or more painful points is necessary. But often, and in some patients, not all points are painful, especially in men, which would not invalidate the diagnosis.
18 FM Points
If you’re suspicious of having fibromyalgia, you should first inspect the following 18 pain points. Afterwards, you should visit your doctor to confirm that diagnosis.
- Back neck pain – 2 points
- Tenderness in the elbows – 2 points
- Pain in the front area of the neck – 2 points
- Hip pain – 2 points
- Lower back pain – 2 points
- Troubles with the knees – 2 points
- Pain in the upper back area – 2 points
- Shoulder tenderness – 2 points
- Tender points in the chest area – 2 points